Definition and Barriers to Evidence-based Practice (Nursing)

00:01 Welcome to “Evidence-based Practice.” Otherwise known as, “EBP.” You're going to hear this term a lot in nursing school and in the health care field.

00:12 Just note, that your health care team, makes decisions every day that impact patient care.

00:18 But these, are actually based on evidence, from research and patient outcomes.

00:24 So before we get started, we've got to ask the question, what is evidence-based practice? This is actually a problem-solving approach that, consciously integrates that best practice, into clinical decision making involving patient care.

00:41 Now, there are some challenges when we're talking about EBP.

00:45 We've got to make sure as clinicians and for clinical decision making, that we find the best information, definitely the most current information and using that information and finding it at the right time.

00:59 Now, let's talk about as nurses how we make those safe decisions.

01:03 Well, we use a lot of different data points.

01:06 So, we definitely get that evidence from literature and hopefully it is the most current.

01:11 Remember, that's an important point for evidence-based practice.

01:15 We also take evidence from our patient assessment, our clinical expertise and of course, important to integrate the patient's preferences and their values.

01:26 So here on this slide, you see the scientific method, know that evidence-based practice, is also a systematic and an orderly way to make decisions much like the scientific method here.

01:41 So, let's talk about something called a, “Plan Do Study Act.” Many times, as a new nurse on their unit, we love to get a fresh perspective, because many times there's different practice changes or maybe things that we can improve.

01:57 And we call that a quality improvement project.

02:01 And many times that comes straight from the nurse's perspective, on things again that can help improve, patient outcomes, patient satisfaction and patient safety.

02:11 So, here's a great guideline, on how to do a quality improvement project on your particular unit.

02:18 So, again we call this, “Plan Do Study Act.” When we start with the plan process, we're going to review certain information and identify what practice gap or improvement that we can make and identify that need for change.

02:33 Then, we can select and actually implement that change.

02:36 Then, we've got to make sure how's the outcome, what are the results are going to look like.

02:42 Then we can do the act phase, where we implement those positive outcomes into actual practice.

02:48 Now, here's a great point to were with this, as you see in this image it goes in a circle.

02:53 Sometimes, we may have to redo this PDSA cycle, if those outcomes weren't what we wanted.

03:00 We can restart the cycle and adjust, for what is needed for that clinical practice.

03:07 Let's take a look at some very common examples, of evidence-based practice put in the clinical practice today.

03:14 So this first box that you see, we are talking about the most current evidence, as you remember it's got to be current, is to no longer pre-test the balloon for insertion of a catheter.

03:27 Now, what we're talking about here is if you look at this image, there is a balloon that seats in the bladder of the patient.

03:35 We used to take our syringe inflate, the balloon before insertion, just to make sure the integrity of the balloon was okay and we could insert for the patient.

03:45 However, new evidence says, to no longer pre-test that balloon, because it can actually damage the integrity of the balloon, once we insert it in the patient.

03:57 Now, the next one that you're going to see, is what we call the “VAP protocol.” This is to prevent pneumonia in ventilated patients.

04:04 And there's so much evidence and literature out there, about this particular protocol and it is widely used across the country.

04:13 You may see this particular protocol used in intensive care units or any unit that you will see a ventilated patient.

04:21 Now, these last two you may be a little bit more familiar with, especially, in your nursing studies.

04:27 Scrubbing the hub of any IV hub is really important, to decrease infection risk before use.

04:34 And lastly of course that all-important hand hygiene, to decrease transmission of microorganisms.